New Zealand Society of Anaesthetists (NZSA) – Level 1, Central House, 26 Brandon Street, Wellington 6011
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President's blog

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Changes afoot explored at NZSA Forum

June-July 2017

We certainly live in interesting times. They are times of danger and uncertainty; but they are also the most creative of any time in the history of mankind.” Robert F. Kennedy, 1966

 

American politics right now are entertaining but also rather frightening. I have just read an article “Deep Breath America,” which explains the lead up to the appointment of Robert Mueller as a special prosecutor and some of the possible resulting scenarios. It is somewhat restoring my faith in the political checks and balances that I thought existed in American politics. Anyway, Putin seems to be enjoying it….

I was lucky to be one of the over 2000 delegates at the recent ANZCA ASM In Brisbane. The theme was ‘Think Big’ and there was certainly a lot to think about. The lecture I have most thought about is “Balancing the Scales: Gender Representation at Scientific Meetings” by Professor Jenny Martin.

I found her message challenging and somewhat confronting. Others felt similarly, from the conversations I heard following her talk. I related to her message as I am on the organising committee for the Rotorua ASM (8-11 November 2017) and as a committee we fall into the traps she spoke about in relation to:

  • unconscious bias, and
  • the invisible privileges that result.

She said that our society’s bias is to stereotype women as homemakers and men as speakers at scientific meetings and this confers on men an invisible privilege or propensity to be selected for both committee positions and as speakers. Without realising it, our committee was initially all male and we mainly considered male speakers for the conference. We did not set out to do this and it was in no way intentional, but we had unconsciously adopted the bias which exists in our society.  Fortunately, as an organising committee we don’t quite qualify for the Hasselhoff Award (Allmalepanels.tumblr.com) but we came close.

I have reflected on biases further and the concept was hammered home when I was walking through the hospital with my daughter. She had a temporary job within the hospital recruiting for the Waikato Hospital Virtual Health Scheme (another story) and she made the comment that simply by walking alongside me her status had changed from “poor to reasonable.” A colleague however has told me this was most likely due to my position in the hospital, rather than my gender. But she also made the point that as a middle-aged, middle-class white male there are various unconscious biases and invisible privileges that I benefit from which I should be more aware of. Daniel Kahneman refers to this phenomena in his book “Thinking Fast and Slow.”

I was also reminded that the upcoming NZSA Forum (more on this below) was organised by the women of the NZSA and female speakers feature prominently.

If you have read my previous blogs you will know I repeatedly quote from the NZSA’s Safety Through Knowledge publication – also coined the Golden Book (a brilliant retelling of the NZSA’s history). The need to keep up-to-date on current issues was as much a focus at the time the Society was formed, as it is today. There are changes afoot and we need to come up from the depths of our often, over-committed lives and take note. To this end we have planned an Anaesthesiologists’ Forum on 29 July at the University of Otago, Wellington. The Forum will focus on recertification and competency – very topical issues in the context of MCNZ’s proposed changes. Forum speakers will address competency from different angles, including competency based medical education, and the ageing anaesthetist and peer support.

There are many changes in our health system, and we need to better know how they will affect us and how we can better respond and support each other.

Here are some highlights from our upcoming forum:

  • Representatives from our two networks: obstetrics and paediatrics will update attendees on core issues affecting these subspecialties. I’ve been privileged to watch them develop and am strongly supportive of the underlying philosophy of facilitation and communication amongst subspecialty groups, within our unique New Zealand context.
  • The Medical Sciences Council is currently reviewing the scope of practice for Anaesthetic Technicians. Two Nurse Assistant courses are in progress. So how will these developments affect the Assistant to the Anaesthesiologist? Clearly a crucial topic. At the time of writing, these changes are under discussion and we are awaiting further information. It’s my impression that there will be changes both in the education pathway and in the capabilities of the final product. The training options for registered nurses wishing to be AA’s is also undergoing change.
  • IT: We are exceedingly lucky to have Lara Hopley, who is on the cutting edge of health IT development, speaking at our forum again.
  • Neuromuscular blocking: Arguably the most dangerous group of drugs we use. The rules are changing here; we will have a perspective from a local expert.
  • Private Practice: Somewhat paradoxically for a Society president I do not do any private practice. However, there are subtle and not-so-subtle differences between public and private. We are fortunate to have Ian England, the President of the NZ Private Surgical Hospitals Association, speak to us on recertification, from a private hospital perspective. There may be changes to your credentialling at private facilities so you need to be informed about what this may involve.
  • ACC: There are a number of new initiatives. Mark Featherston, our Private Practice Subcommittee Chair, will be presenting, along with a representative from ACC whose interest is treatment injury and also the collaborative work being undertaken on the MORSim project.
  • MCNZ CEO Philip Pigou will talk to us about the Council’s proposals to strengthen recertification for vocationally registered doctors. What changes are they wanting to implement? What will it mean for you?
  • CPD: Come and hear the latest from one of our college councillors Vanessa Beavis who established the CPD programme.
  • Competency Based Medical Education: Jennifer Weller will update us also, presenting the work she is doing with the College in Ireland.
  • The ageing anaesthetist: welfare and support of our colleagues is essential near the end of our anaesthetic careers as we potentially become more isolated in our practices. We will reflect on how we can offer better support to this group.
  • The Orthopaedic Association has been running a peer support programme and will share insights about recertification, from an orthopaedic perspective.

You can see the full programme and register for the forum here

We look forward to seeing you!

As always, may the force be with you.

David